What to Expect in a Normal Delivery

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Station of the cervix; admission

Station of the Cervix The station of the baby is based on the relative distance of the baby's presenting body part (the head) to the level of the patient's ischial spines. These ischial spines are part of the bony portions of the mother's pelvis that the doctor or nurse can feel during the exam. A station is described as being anywhere on a scale from -5 to +5 with 0 being at the level of the ischial spine. If the baby is at 0 station, then the top of his head is at the level of the ischial spine. If the baby's station is a positive number, that means that the baby has moved farther down the birth canal past the ischial spine (ergo, closer to delivery).

Putting It All Together Typical doctor lingo for a woman in labor might be something like this: 4 cm. dilated/50% effaced/-1 station. Translation: The cervix is 4 centimeters open. An effacement of 50% means that half of the cervix is thinned out (or the thickness has decreased by half). And -1 refers to the baby's presenting part or head being -1 cm. above the ischial spines.

If you are having regular contractions with the above diagnosis, then you have passed from the latent phase of labor (or the slow portion of the first stage) into the active phase of labor (or the faster portion of the first stage). For a first-time mother, once she has entered the active phase of labor, then the baby usually will be delivered within 8-12 hours, if not sooner. Patients at the active phase of labor are admitted to the hospital because the chance that the baby will deliver within several hours is fairly high, and the doctors and nurses will want to monitor the patient very closely during this time. This is the phase where the mother and baby are at higher risk for potential complications.

Admission Once you are officially admitted and taken to a labor and delivery room, the nursing staff will go over certain items with you. They will ask you questions, some of which you may have answered already at your doctor's visits. For example, they will review your medication history and potential allergies. Your doctor (or a nurse) will explain what happens during labor and delivery, if he has not already done so, and go over potential procedures that may or may not need to be performed. Once you have an understanding of what will happen, you will sign a patient consent form, which implies that you understand what will occur in labor and delivery. This time is also your opportunity to ask questions.

The question and answer period serves as a protective mechanism for both the hospital and the patient. Some topics that might be discussed with you are the possibility of using forceps, having an episiotomy, what conditions might warrant a c-section, and so on. The patient is protected by virtue of the fact that she knows what is going to happen before it happens (in the best of all possible cases). The hospital and medical staff are protected because they have proof that they told the patient what they were going to do in order to take care of her.

A Chance For Partners to Earn Their Keep During this process of admission, you are going to be distracted by contractions and not at your best or sharpest mentally. Your entire focus is on your body and the impending birth of your baby. It's important that your husband, partner, significant other, or coach be alert and attuned to what the nursing staff is explaining. If you don't fully understand what is going on or what the staff is saying, that's OK. Perhaps your partner can explain it to you later. Rely on your partner to go back to the doctor or nurse and get a more satisfactory or fuller explanation, if necessary.

Another tip: You might want to have your partner take a notebook so that he or she can jot down your questions. Or you could prepare some questions in advance. The important thing to remember is that your partner is your advocate. Make sure that person realizes his or her role in your delivery process and just how valuable that role is. (On the other hand, don't let them be too obnoxious, constantly pestering the medical staff and diverting attention from you  it does happen occasionally.)

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